A study by Chou et al has shown that
patients on topical alpha-2 adrenergic monotherapy have a significantly higher
risk of developing Alzheimer’s disease (AD).
The nationwide population-based cohort
study utilized insurance claims data from Taiwan’s National Health Insurance
Research Database between 2008 and 2019. Participants were adults aged 45 years
or older either with a diagnosis of glaucoma or without.
There were 202,000 participants included in
the study, with 101,000 in each group (glaucoma and control groups).
Those with glaucoma received at least one
antiglaucomatous medication (including α2-adrenergic agonists, cholinergic
agonists, beta-blockers, prostaglandin analogs, and pilocarpine) for over 90
days. Those with pre-existing AD diagnoses before the index date were excluded.
Glaucoma patients on topical alpha-2
adrenergic agonist monotherapy exhibited a significantly higher AD risk (aHR
1.15, 95% CI = 1.01–1.31)
compared to those on beta-blockers.
Irrespective of the type of glaucoma,
individuals with glaucoma had a significantly higher risk of AD compared to
those without glaucoma (POAG: aHR 1.23, 95% CI = 1.08–1.40;
NTG: aHR 1.49, 95% CI = 1.19–1.85;
PACG: aHR 1.35, 95% CI = 1.19–1.52;
unspecified glaucoma: aHR 1.36, 95% CI = 1.23–1.50).
The study concluded that topical alpha-2
adrenergic agonists might pose increased AD risk in individuals with glaucoma
compared to beta-blockers. Therefore, they should be used cautiously,
especially in middle-aged and older populations. The findings also suggest that
glaucoma, regardless of the type may increase the risk of AD.
REFERENCE:
Chou, CC., Lu, YA., Weng, CH. et
al. The association between antiglaucomatous agents and Alzheimer’s
disease. Eye (2024). https://doi.org/10.1038/s41433-024-03348-y
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